115 APPLICATION F,OR HOUSE MOVING PERMIT
.I YI OF CUPERTINO
JUL 18 1963 ) (/ -
Date 19 �C Permit No.
CITY 0'- CUFee $, n
Application is hereby made to the City of Cupertino for a permit to move the building
described on the reverse side hereof from and to the specified location at the time and date
indicated in accordance with Ordnance No. _of the City of Cupertino.
Owner
U
u By�
�A
�NTRppr*BUILLDING
ACTOR, AGENT
INSPECTOR
Phone ------------------------------------
Building contstructed of //>dr`i1/ 4No. of Rooms
J
MATERIALS Width
Height
Condition of exterior o
Condition of interior
Present locatio D ' /
No. Street Lot Block Tract
Proposed location.
No. Street Lot Block Tract City
Site location on new lot
Route on which building is to be movedT6tig)
Tax certificate filed Ownership certificate filed Fee Deposited,-)e
Other information